Too many patients are treated in the emergency room
A recent study shows that the emergency department of hospitals appears to be used by too many patients. Around every fifth patient is wrong in the emergency room.
Around 20 percent wrong in the emergency room According to a study, around 20 percent of the patients who were treated in a hospital emergency room could also have received other care. The examination with almost 5,000 patients was presented yesterday at the conference of the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) in Hamburg. In addition, there is a trend that more patients generally come to the emergency room. According to DGINA projections, around a quarter of the German population visits an emergency room at least once a year.
General practitioners would often be sufficient. For the current survey by Hamburg clinics, the doctors evaluated data from 4,927 patients who were treated over a period of 16 days. The patients came both by ambulance and through instruction from resident doctors or on their own. As Michael Wünning, spokesman for the group of chief physicians in interdisciplinary emergency departments in Hamburg, said, seven percent of these patients would have had other medical professionals such as general practitioners or emergency services directly available.
Patients misjudge complaints These doctors could also have been reached within a reasonable time in ten percent of cases. "If I wake up with a cough at four in the morning, in most cases it is probably reasonable to wait until a resident doctor has opened," said DGINA conference president Wünning. The severity of the complaints was misjudged in three percent of patients' cases or it was simply a matter of need for nursing measures, such as a wound dressing.
No blame The examinations are not about blaming, they are meant to be an inventory so that you do not have to act according to a gut feeling. So far there are no comparative figures from previous years. “There are reasons why patients act in this way, they obviously have concerns and understandable suffering. Of course they are treated by us. However, we have to adapt to them with our structures, ”said Wünning from the Catholic Marienkrankenhaus.
Specialist in emergency medicine required From the point of view of emergency physicians, the problem of emergency admissions is a result of decades of neglect of their specialty. In 16 EU member states as well as in the USA there is a separate specialist for emergency medicine. In Germany, however, traditionally, several disciplines feel called to provide quick help. The aim of the DGINA is to change this step by step. DGINA President Christoph Dodt from the Munich Municipal Clinic has an intermediate step towards becoming his own specialist in emergency medicine so that he can create an additional qualification for specialists with two years of additional training by 2015. The training as a specialist should last five years. The President of the European Society for Emergency Medicine (Eusem), Barbara Hogan, is certain that her own specialist would also benefit the patient, because the emergency medicine specialists are experts in all acute diseases and can either act themselves or quickly find the right specialist to become one Get patient.
Emergency doctor questioned Above all, the emergency physicians must convince the doctors in the medical parliaments of the federal states, the medical days and the medical associations if they want to achieve their goal by their own specialist. Therefore, it is a possible incentive that the statutory health insurance associations that are responsible for the on-call service and the emergency medical services are having increasing difficulties in filling these positions. One way out could be a centralized concentration of emergency care at clinics, of which the DGINA President spoke at the conference. The discussion about a specialist in emergency medicine also questions another German specialty: the emergency doctor who comes to the patient. In numerous countries around the world, the patient is transported to the doctor by well-trained rescue personnel, and given the medical resource problems, the question arises as to how long it will still be the rule in this country that doctors also come to the patient.
Financial shortages At the conference, the DGINA also complained of "gross underfunding." According to projections, at least 21 million such treatments for patients would be carried out annually, but this would also include the number of patients admitted to the hospital after the treatment. Doctors could save fees of an average of 30 euros for outpatient treatment for those insured by law. However, the real average costs should be between 120 and 150 euros per treatment. Therefore, the company demands a flat rate that covers the costs actually incurred. Timo Schöpke of the Vivantes Klinikum am Urban put the gap in coverage that arises in the German emergency rooms annually at at least one billion euros. (ad)
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